Treasury generates Form FMS-1133 (Claim Against the United States for the Proceeds
of a Government Check) when the Social Security Administration (SSA) inputs a nonreceipt
or stop payment request for Title II or Title XVI checks. The form contains questions
the beneficiary, recipient or representative payee must complete in order to assist
Treasury in determining if the check in question is forged.
If the beneficiary, recipient, or representative payee loses or does not receive the
form, the field office (FO), Teleservice center (TSC) or program service center (PSC)
may do a one-time print of the FMS-1133 from the Treasury Check Information System
(TCIS). If FO or TSC personnel need additional printed forms, contact the Regional
Office through normal communication (vHelp); PSC personnel can contact their Operations
Analysis Staff, or contact Treasury at 855-868-0151, if necessary. The form is available
for print until Treasury receives the completed FMS-1133.
Treasury will not provide the form when SSA uses a non-permanent stop code to request
a certified photocopy (L-stop).
NOTE: Do not input regular photocopy or status requests through the SSA system because
this information is available on TCIS.